HomeMy WebLinkAboutX2019-0424 - Permit ApplicationI' Print Form -
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Worksheet for Combo Building & Solar Permit Application
Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Y201g.0t1941
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ming rGrading rDrainage ["Efec rMech F- Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) C Flood r Fire F_ Liq F7 Landslide F_N/A Floor Suite No
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X1201
4- y3o1 SC4mborte_ act —
Description of Work
Use F—ConstType . 6—?n,5
# Storie- # Units (if Res)F_
10) eXi2roally 'llflArrt Corner monUmen+-$'-711LX Ll'L"h on Shorn
C Its/ 17 ' G " 1- h�v5.(3nvn.lurn
on Indr
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5 llurn pnumerals
Valuation
New/Add SF� Garage/New/Add �
Remodel SF �
Material/Labor
OWNER'S NAME Last The P(•[•erne (/roup First irlcyH 8polrarl
Owner's Address Owner's E-mail Address
5000 Birch Sf./xt (ADD mbcyc$rrint?PI0errgroup.Cavy1
City %JLI� Or% pe CV1 State /1 ZI �&D Telephone 9/aq,Z(�7./SZG�
a !� G CQ Zip
APPLICANT'S NAME Last e d h l `� First
Applicant's Address Applicant's E-mail Address
2231 ,s•_ Det pon+ Dr. Conde(C-)SignC, e SolU+lions . CJn�I
N
City ; rIG% � 1 r l State Zip Q2-' jo(o Telephone 7/y .31 b 7&SL/
AREHfTECTtB€SIONEWS NAME
Last YJ n First Lic. No.i)oIneer-� I 0 Z
ArchiteCh/Designer's Address ArchitecttDesigner's E-mail Address
P. o, f)ok (a)oZ os D _ YOUl-F@YJI'n c - el) m
City SCm--�a _C l a r O -C4, State C Zip Fq 1< j JI D Telephone G (r/ • 2S-4? � 07 00
ENGINEER'S NAME Last First F_ Lic. No.�—
ineer's Address Engineer's E-mail Address
City State F Zip F Telephoner
CONTRACTOR'S NAME/COMPANY 1@ ni 2 2 lJ' D_l tx+i6nS Lic. No. 500Z2�- Class e LIs"
V
Contractor's Address Contractor's E-mail Address
_
2231 S . Du.porrr D r . Oand I �m 10 nay 2 - Sz)l N+i ()/-)S . ('a r>-1
City State Zip Telephone �lll, (�( 1. CzTT
l<I r)Gl he l k -n F 2°JO(.p _. P
rk E
SETBACKS REAR SETBACKS FRONT PERMIT NO. >--L6 � I � (Dt4 Z
SETBACKS LEFT SETBACKS RIGHTI PLAN CHECK NO. ®�j(�6
USE ZONE DEVELOPMENT NO 0/ 3 - 0� 3 1 PLAN CHECK FEES $
M